Wrist Fracture

A wrist fracture is a break in one of the bones of the wrist. Your wrist is made up of several small bones at the palm of your hand (carpal bones) and the two bones that make up your forearm (radius and ulna). The bones come together to form multiple large and small joints. The shape and design of these joints allow your wrist to bend and straighten, move side-to-side, and rotate, as in twisting your palm up or down.

CAUSES

A fracture may occur in any of the bones in your wrist when enough force is applied to the wrist, such as when falling down onto an outstretched hand. Severe injuries may occur from a more forceful injury.

SYMPTOMS

Symptoms of wrist fractures include tenderness, bruising, and swelling. Additionally, the wrist may hang in an odd position or may be misshaped.

DIAGNOSIS

To diagnose a wrist fracture, your caregiver will physically examine your wrist. Your caregiver may also request an X-ray exam of your wrist.

TREATMENT

Treatment depends on many factors, including the nature and location of the fracture, your age, and your activity level. Treatment for wrist fracture can be nonsurgical or surgical.

For nonsurgical treatment, a plaster cast or splint may be applied to your wrist if the bone is in a good position (aligned). The cast will stay on for about 6 weeks. If the alignment of your bone is not good, it may be necessary to realign (reduce) it. After the bone is reduced, a splint usually is placed on your wrist to allow for a small amount of normal swelling. After about 1 week, the splint is removed and a cast is added. The cast is removed 2 or 3 weeks later, after the swelling goes down, causing the cast to loosen. Another cast is applied. This cast is removed after about another 2 or 3 weeks, for a total of 4 to 6 weeks of immobilization.

Sometimes the position of the bone is so far out of place that surgery is required to apply a device to hold it together as it heals. If the bone cannot be reduced without cutting the skin around the bone (closed reduction), a cut (incision) is made to allow direct access to the bone to reduce it (open reduction). Depending on the fracture, there are a number of options for holding the bone in place while it heals, including a cast, metal pins, a plate and screws, and a device called an external fixator. With an external fixator, most of the hardware remains outside of the body.

HOME CARE INSTRUCTIONS

  • To lessen swelling, keep your injured wrist elevated and move your fingers as much as possible.

  • Apply ice to your wrist for the first 1 to 2 days after you have been treated or as directed by your caregiver. Applying ice helps to reduce inflammation and pain.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15 to 20 minutes at a time, every 2 hours while you are awake.

  • Do not put pressure on any part of your cast or splint. It may break.

  • Use a plastic bag to protect your cast or splint from water while bathing or showering. Do not lower your cast or splint into water.

  • Only take over-the-counter or prescription medicines for pain as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your cast or splint gets damaged or breaks.

  • You have continued severe pain or more swelling than you did before the cast was put on.

  • Your skin or fingernails below the injury turn blue or gray or feel cold or numb.

  • You develop decreased feeling in your fingers.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.